Hepatitis B e antigen-negative chronic hepatitis B in Hong Kong
Hepatitis B e antigen-negative chronic hepatitis B in Hong Kong
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DOI：
10.1002/hep.510310330
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发表时间：
2000-03-01
期刊：
影响因子：
13.5
通讯作者：
Lok, ASF
中科院分区：
文献类型：
--
作者：
Chan, HLY;Leung, NWY;Lok, ASF
乙型肝炎e抗原阴性慢性乙型肝炎（e- chb）在亚洲有报道，但其患病率和临床意义尚未确定。本研究的目的是确定香港e-CHB的患病率以及这些患者中前启动子和核心启动子突变的频率。一项横断面研究对350名慢性乙型肝炎病毒感染的连续中国患者（230名男性和120名女性，平均年龄+/- sd， 42 +/- 13岁）进行了研究。共有243例（69%）患者为乙型肝炎e抗原（HBeAg）阴性，其中15%为临床肝硬化，其余85%患者中，63%为正常，22%为转氨酶升高，在46% HBeAg阴性的临床肝硬化/转氨酶升高的患者中，采用支链DNA检测血清乙型肝炎病毒（HBV） DNA。45%的e-CHB患者有前终止密码子突变，另外41%的患者有核心启动子改变。前核/核心启动子突变的存在与肝脏疾病或HBV-DNA水平之间没有相关性。总体而言，17%的hbeag阴性患者是病毒血症，并有慢性肝病（e-CHB）的证据，其平均HBV-DNA水平与hbeag阳性患者相当。总之，我们发现在香港的三级转诊中心，高达17%的hbeag阴性患者可能存在e-CHB， e-CHB可能是一种异质性疾病，并不一定与HBV前突变相关。需要进行人口研究，以确定e-CHB在亚洲的真正流行情况，并评估其自然病程和对治疗的反应。
Hepatitis B e antigen-negative chronic hepatitis B (e-CHB) has been reported in Asia but its prevalence and clinical significance have not been determined. The aims of this study:were to determine the prevalence of e-CHB in Hong Kong and the frequency of precore and core promoter mutations in these patients. A cross-sectional study was performed in 350 consecutive Chinese patients (230 men and 120 women; mean age +/-SD, 42 +/- 13 years) with chronic hepatitis B virus infection. A total of 243 (69%) patients were hepatitis B e antigen (HBeAg)-negative of whom 15% had clinical cirrhosis, In the remaining 85% of patients, 63% had normal and 22% had elevated transaminases, Serum hepatitis B virus (HBV) DNA was detectable using branched DNA assay in 46% of HBeAg-negative patients with clinical cirrhosis/elevated transaminases. Forty-five percent of the patients with e-CHB had the precore stop codon mutation, and an additional 41% had core promoter changes. There was no correlation between the presence of precore/core promoter mutations and liver disease or HBV-DNA levels. Overall, 17% of HBeAg-negative patients were viremic and had evidence of chronic liver disease (e-CHB) with mean HBV-DNA levels comparable with that in HBeAg-positive patients. In summary, we found that e-CHB may be present in up to 17% of HBeAg-negative patients seen in a tertiary referral center in Hong Kong, e-CHB may be a heterogenous condition and is not invariably associated with the precore HBV mutant. Population studies are needed to determine the true prevalence of e-CHB in Asia and to assess its natural course and response to treatment.